The temporal correlation between positive testing and death in Italy: from the first phase to the later evolution of the COVID-19 pandemic

  1. Vincenzo d’Alessandro
  2. Nicole Balasco
  3. Pietro Ferrara
  4. Luigi Vitagliano

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Abstract

After the global spread of the novel coronavirus disease 2019 (COVID-19), research has concentrated its efforts on several aspects of the epidemiological burden of pandemic. In this frame, the presented study follows a previous analysis of the temporal link between cases and deaths during the first epidemic wave (Phase 1) in Italy (March-June 2020). We here analyze the COVID-19 epidemic in the time span from March 2020 to June 2021. The elaboration of the curves of cases and deaths allows identifying the temporal shift between the positive testing and the fatal event, which corresponds to one week from W 2 to W 33 , two weeks from W 34 to W 41 , and three weeks from W 42 to W 67 . Based on this finding, we calculate the Weekly Lethality Rate (WLR). The WLR was grossly overestimated (~13.5%) in Phase 1, while a mean value of 2.6% was observed in most of Phase 2 (starting from October 2020), with a drop to 1.4% in the last investigated weeks. Overall, these findings offer an interesting insight into the magnitude and time evolution of the lethality burden attributable to COVID-19 during the entire pandemic period in Italy. In particular, the analysis highlighted the impact of the effectiveness of public health and social measures, of changes in disease management, and of preventive strategies over time.

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  1. ScreenIT

    SciScore for 10.1101/2021.07.14.21260505: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Data were analyzed with MATLAB R2014b and R statistical software v.
    MATLAB
    suggested: (MATLAB, RRID:SCR_001622)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Some limitations of our study should be acknowledged. First, as for our previous analysis of lethality during the first epidemic wave (8), the research included information measured through surveillance systems where data were provided in aggregated form and without any case stratification; thus, it was not possible to evaluate uncertainty sources and adjust results for potential independent predictors of death, but this research was intended as a straightforward strategy to assess the time-trend of the proportion of cases who died from the disease. Second, the WLR uses the number of subjects that tested positive as population (denominator), thus being influenced by the number of tests performed on a certain time-point. However, the combination of data on a weekly-aggregated manner greatly reduced possible differences across different week-days. Lastly, even if the 1- to 2-week and 2- to 3-week shifts were based on static denominators, the WLR calculated a ratio representing relative rates of deaths which reflect analytical expressions of lethality proxy over time. In conclusion, our study provides interesting insights into the evolution of the COVID-19 pandemic in Italy by highlighting some distinctive features, in terms of trend complexity of the lethality rate in the different phases of the pandemic. Our approach also documented the impact of the public health measures on SARS-CoV-2 spread and associated lethality, also highlighting the possible positive effect of vaccinat...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

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  2. Version published to 10.1101/2021.07.14.21260505v1 on medRxiv